In this installment of the “How I treat ...” series in Blood, the authors use four case studies to describe their approach to treating adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL). Recent studies using pediatric regimens in this population (up to age 39) has shown improvements in event-free survival rates ranging from 60% to 70%. The authors discuss the use of prognostic markers such as minimal residual disease (MRD) and note that high-risk patients with persistent MRD following early consolidation therapy should be referred for transplant consultation. The authors discuss the biology, pharmacology, and psychosocial aspects of AYA patients, and note that a holistic approach, incorporating a multidisciplinary team, is key to successful treatment.
Review: ALL in Older Adolescents and Young Adults